Join me as I half-ass my way through medical school, encountering all sorts of freaks (patients, classmates, myself, etc.) along the way

Sunday, May 07, 2006

Medical Myth Busters

Myth #291: Being a doctor is unlike any other job.

After my freshman year of college, I took a job at a large aerospace firm because, well, it should be obvious to you by now that I am a slut for money, and this particular company offered to pay me ridiculous amounts of money to play Hollywood Stock Exchange and Snood with my cubicle-mate for an entire summer (in case you’re keeping score, that’s Effeminate Loser 2, Maintaining Any Sense of Dignity 0). However, while at this job I couldn’t help but notice that the hierarchy of this company reflected the ultimate stereotype of corporate life, such that the people at the top were inconsiderate fools and everyone else did their best jobs to smooch any open orifice these fools had in order to get ahead at the expense of their collegues, sheer incompetence not really playing into who did or did not get promoted. In essence, one summer at this job taught me that Office Space was far more realistic than I could have ever imagined.

Nuts to that, I declared triumphantly (to no one in particular, prompting the tragic "Oy our son is crazy!" fiasco of 2000...don't ask) at the conclusion of that summer. After speaking with enough doctors and medical students over the next few years, I started getting the impression that such hierarchical nonsense did not really happen in medicine, because everyone was equal, all colleagues singing songs and holding hands in a valiant display of mutual respect as they circled around a campfire burning with love (and maybe some fire).

Unfortunately, I have learned that this campfire does not exist, but instead is a mirage meant to disguise a disappointing reality. Case in point, last Thursday, when I was subjected to yet another afternoon with a certain attending at an endocrinology clinic who enjoys nothing more than embarrassing me in front of patients as much as possible. I have grown accustomed to such treatment, which usually goes something like this:

Attending: And what do you think is going on here?Me: [Another brilliant explanation]Attending: You couldn’t be further from the truth! [Laughs at me while patting patient on the back, who also begins laughing and pointing his or her finger at me]

Fine. I’m over it. However, last Thursday we were joined in clinic by an endocrinology fellow (meaning he had completed medical school and a residency, putting him at least five years ahead of me in training) there to help out. I introduced myself to him like so:

Me: Hi, I’m the third year with you in clinic today.Fellow: OK. Third year resident?Me: No, medical student.Fellow (disgusted): Oh lord.

Lovely. Clinic was moving along rather slowly, so I decided to join the fellow while he did a work-up on a new patient. There were not enough chairs in the room, so I was forced to stand in a poorly ventilated room for an hour and a half while this fellow fumbled through a history and physical, taking forever on a task that even a moronic third year medical student could have done in half the time (and me in less than an hour, tops). Yet, I kept my mouth shut and just suffered through it.

I saw the next patient on my own, finishing the workup in about 30 minutes. I presented to the attending and we saw the patient together for another 15 minutes, for a complete workup total of 45 minutes. While walking out of the room, the fellow approached me from across the hall and, under his breath, spewed out rather angrily “What the hell took you so long? You're still on that patient?” Excuse me?

Soon thereafter, we had seen all the patients in clinic. The attending began his “You can leave” speech, but the fellow interrupted him and asked a lengthy academic question that served no purpose other than to signify his fondness for the attending’s rectum, because this question directly resulted in the attending saying the magic(ally horrific) words, “Why, I have some slides on that! Let’s go to my office and I’ll give a little talk!”

Seriously, kill me now. I followed them into the office and sat through the talk, the bulk of which consisted of the attending spending almost 30 minutes trying to explain a relatively simple concept to the fellow, who was so dimwitted he simply could not get it. Again, recognizing my place in the world, I just kept my mouth shut while the attending and the fellow went back and forth trying to tease out what was clearly stated on a stupid powerpoint slide. When the fellow finally got it, the attending realized that I had been silent for a while now, which led to the following exchange:

Attending: OK, does that make sense now?Fellow: Thank you so much for that talk, that was really great!Attending: Well, it looks like our friend here [pointing at me] is not really interested in our intellectual conversation, how about we call it a day for him?[Attending and fellow laugh at me]

Ladies and gentlemen, the medical world is not some fanciful place wholly different from the corporate world, the legal world, or any other economic or social construct. The same rules of success apply, whether that means sucking up, making other people look bad, or doing whatever it takes to get ahead. I was probably just a victim of being especially naïve, but I honestly believed that there was something fundamentally different to the medical hierarchy, that even though there was a totem pole, people did not have the same pressure to abuse that pole at the expense of their colleagues in real-life practical settings.

Even more so, I learned that currently I am not merely at the bottom of the totem pole. The totem pole is mercilessly beating me across the head, smashing my insides out and my outsides in, and smothering any shred of dignity that might remain after you account for those ridiculous short white coats they make us wear and the aforementioned Snood I used to play from time to time.

Being a doctor may be unlike any other job in the world, as we are privy to the private experiences, fears, and hopes people would not share with almost any other soul…but, paradoxically, being a doctor is also just like every other job in the world, and I’m embarrassed to admit that I did not appreciate this until now.

Next time, I shall ruthlessly debunk Myth #47: There is at least a minute shred of truth to the drama depicted on Grey’s Anatomy.

40 Comments:

Man, that sounds like a tough gig. I have also been recently disallusioned my the great almighty Peace Corps. I thought there would be campfire singing and love all around. In a similar fashion, I was proved wrong and realized it's like everything else. There are some great things, but so many things are bad and I just didnt expect that.

I'm right there with you. I used to think that the smartest, hardest-working employees in [insert any field] are the ones who get ahead. As I grow older, I'm learning that politics are a much larger percentage of the equation that I originally thought.

I'm figuring out that I'll never excel past a certain point in my career for the stupid reason of my lack of desire to ever golf.It kills me to watch a co-worker (with much less experience- hell, less intelligence) sidling up to the Boss Man and ask him to play golf over the weekend- and shortly thereafter get assigned to a sweet project. Grrr.

You see, I thought your post was hysterical because of all the people in medicine who have told me to go into business because medicine is SOOOOOOO HORRIBLE because of the situations you have just described. I'm kind of like, um, yeah, have you ever worked in business? I never understood how a person could become an alcoholic until I spent a year working at a consulting firm.

I will tell you this however. At least in medicine there is a guarantee that you will move up and out. You only have to work with said Endo prick for a short amount of time, and the you will eventually be a fellow yourself (and then an attending). Can you imagine being stuck, promotionless, in a business job with that prick for years and years and years. Only to be laid off with two weeks notice to have to find another shitty business job with likely lower pay and another sucky boss? Trust, me it could be a whole lot worse.

Just make sure you don't perpetuate the cycle of prick-dom yourself when you do move up.

I know exactly what you mean! Politics has always been a tough game for me to play. Aah and there is another way to play the game. Its not who you know, its what you know. :-) sometimes anyway.I had the pleasure of telling two of my bosses exactly what i thought of them before quitting. I hope you get the same opportunity at some point.

I seem to be the only one in miles who is having serious misgivings, the doctors I work with seem to be very happy treating patients likes sweets on a shelf. But I hate it. I've just graduated and am now on a disorganized surgery firm where I start at 0730 and finish at around 7pm. My SHO and REG are nowhere to be seen, and I feel overwhelmed most of the time not by what I do, but by how much I have to do. I love people and patients, love the learning in medicine. But not the oncalls and some of the days, when literally all you do is hand things in and chase things up. If you really want to be a caring doctor you'd never sleep. I now envy the majority of my colleauges who don't care about their patients and as a result are so efficient, making it work for them. I have drastically reduced the time it takes me to admit somebody down to 15 mins, there was absolutely no human touch, a pat on the back from the Reg I happened to be on with that day, and a bit of guilt on my part. I forgot to add on a calcium the other day and my SHO asked me if i was plain stupid. I was about to ask him if he was born ugly or whether his look was a recent thing - but then I remembered the first rule in medicine: don't answer back, agree to everything, and never escalate things. Nobody likes a grass, they don't tend to get good references and all we can really do is silently take our place at the lowest level of this abused family and hope we, or rather I, because it's possible none of you feel like this, don't turn out the same way. I worked in finance before and I do understand work politics - but you just cannot vent in this profession as you can in the city.I am frustrated with the job and the lack of satisfaction when I really enjoyed being a student (and looked forward to running around on the wards)and I'm angry at myself for feeling like this. But I do. And as I write this, I'm kind of dreading going in tomorrow. I had a great weekend with my mates (this lot are non-medical) and saw the sun on the water, felt it on me, chatted nonsense to some random women and had a laugh. It was a million miles away from the hot sweaty ward where I've been jailed. Anyway enough ranting and now for some doing. All I can say is out attitude shapes how we are, and I need to find that endless reserve of positive, people like Bruce Lee and Aristotle did say that situations don't get you down, YOUR reaction to it does. Shit like that really keeps me going. And my pride. My reaction is going to be positive. I've decided. And I hope it lasts, cos the romantic in me is dying I think. Good luck to you all. Good luck to us all.

Sorry you got slapped in the face by reality. Ass kissers come in all shapes and sizes and in EVERY profession. It never ends in medicine either. You will be amazed how different you will be treated in a year or so. June 30th you are a piece of crap 4th year med student; and July 1st of the same year you are a PGY1 that can tell people like Nurse Teresa what to do. It's weird but you will notice your butt gets more kissable as your residency progresses. Sad but true. Just remember why they are kissing it in the first place: because you are a HOT Jewish doctor ;)

Welcome to the real world my friend. Some day you'll look back at all this and wonder how this innocent little boy managed to make it as far as he has without giving up. Hang in there you're not alone.

Illusions and dreams, they do die hard don't they my friend, FD. There isn't a profession out there that politics doesn't matter -- education, medicine, even religion. Keeping your mouth shut in the situations you describe is tough -- good for you for knowing when not to say anything. You, too, will be rewarded someday with your very own sycophants.

I know exactly how you feel. Currently on a particularly tough surgery rotation and I get abused by every member of the health care totem pole from attendings to residents to scrub nurses to the orderlies that transport patients around. There are days when I even question my self worth in the world and why I am working so hard to get beaten down day after day.

I come to realize that it all comes down to money, and if I was getting paid to get my ass handed to me every day I wouldn't mind it so much. So that makes medicine like every other job on the planet...something to put food on the table, nothing more, nothing less. So much for it being all about the patients. But the idealist medical student in me doesn't want to believe that one bit.

I'm not going to say hang in there we have one more year of this before our MD, cause that brings with it a whole lot of other stresses. But we know what type of doctor we want to be. We know that when we get to the stage where we make a difference, we won't let our priorities fall to the wayside. Hang in there dude, there are other cats out there who feel just like you do. Smile and take it, ask for seconds because that's our 'role'. Clerkship sucks on so many different levels, but its finite...remember that.

Excellent summary of something I'm sure we've all felt. I especially like the "kill me now" bit over the slides. I've had that "death by powerpoint" experience too, at 530 just when I was starting to think I might be home at a decent hour. I've actually given up on being the quiet, deferential med student sometimes, and if I get where the attending's going, like you did, I just ask leading questions to try and get the experience over with. I don't know if it works, because I'm developing calluses on the insides of my wrists where I pinch myself to stay awake.

Ah, politics. I never thought I would escape the ass-kissing/hierarchical b.s. once I transitioned from my corporate world life to healthcare. However, I didn't think it would be as bad as it is. As a rookie OR nurse, I have often been treated as badly as the med students (by doctors, nurses, and scrub techs). Cruelty in the OR is blatant - comparable to public flogging in the days of yore; in the corporate world, it lurks in the shadows until a prime opportunity comes along to jump you and drag you into an alley.

I must say, things are getting better for me as time goes on. For you, I think it will be the same. It's just a matter of not losing who you are in the process. Hang in there!!!

*Sigh*Medicine has it's myths doesn't it.Apparently more than most otherlines of work.*Saviours of the universe..defenders of the weak and weary and unwell..Morally irreproachable reincarnates of God*Funny how many of us get hit by reality like a ton of bricks.Hang in there.When you move higher up the totem pole,you shall have your own whipping boy.

lols......well all med students have something in common afterall.n yup we at the dorms are hooked onto greys anatomy too....only it fascinates us......house on teh otehr hand is rare cases u hardly ever get to see.....but informative anyways!

Hello people want to express my satisfaction with this blog very creative and I really like the views of the focus very good indeed Thank you for the helpful information. I hope you keep up the good work on making your blog a success!